[News for adrenal insufficiency].
The congress of the Endocrine Society 2008 approached the diagnostic, etiologic, prognostic and therapeutic novelties of adrenal insufficiency (AI). Diagnosis of AI often requires serum cortisol measurement during dynamic tests. Salivary cortisol measurement was reported to have an equivalent diagnostic performance to serum cortisol and that is even better when CBG levels are altered. Iatrogenic AI is much more frequent than Addison's disease. Two studies have shown that patients with inhaled corticosteroid and opioid treatments should be tested for AI. A Norwegian study reported an increased mortality in the subgroup of young men that presented Addison's disease before the age of 40. Plasma cortisol concentration in patients with current glucocorticoid replacement therapy differs notably from those observed in physiological condition. This imperfect replacement may be responsible for adverse physical condition and impaired quality of life. Two formulations of delayed hydrocortisone tablets with different pharmacokinetics from usual hydrocortisone (DuoCort and Chronocort) are in development. The first study is promising and shows that these formulations better mimick the body's natural cortisol release. Its use in the treatment of AI in patients with congenital adrenal hyperplasia has also been tested.
Nunes
M-L
ML
Service d'endocrinologie, CHU de Bordeaux, Hôpital Haut Lévêque, avenue de Magellan, 33604 Pessac, France. marie-laure.nunes@chu-bordeaux.fr
Tabarin
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D000309:Adrenal Insufficiency / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D015992:Body Mass Index; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000097:blood / Q000378:metabolism; D008017:Life Expectancy; D011379:Prognosis
D006854:Hydrocortisone